Provider Relations Specialist I
Job Description
Cenpatico – Birmingham, AL – Provider Relations Specialist I USA-Alabama-Mobile, USA-Alabama-Birmingham Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider claims issues. Perform training, orientation and coaching for performance improvement within physician practices. * Serve as primary contact for providers serving as a liaison between the provider and the health plan * Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on site and routing to the appropriate party for resolution * Receive and respond to external provider related issues * Initiate entry or change of provider related database information and oversee testing and completion of change request * Investigate, resolve and communicate provider claim issues and changes * Educate providers regarding policies and procedures related to referrals and claims submission, web…
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